Community-based trial of screening for Chlamydia trachomatis to prevent pelvic inflammatory disease: the POPI (prevention of pelvic infection) trial.

BACKGROUND: Pelvic inflammatory disease (PID) is common and can lead to tubal factor infertility, ectopic pregnancy or chronic pelvic pain. Despite major UK government investment in the National Chlamydia Screening Programme, evidence of benefit remains controversial. The main aim of this trial was to investigate whether screening and treatment of chlamydial infection reduced the incidence of PID over 12 months. Secondary aims were to conduct exploratory studies of the role of bacterial vaginosis (BV) in the development of PID and of the natural history of chlamydial infection. DESIGN: Randomised controlled trial with follow up after 12 months. SETTING NON-HEALTHCARE: Common rooms and lecture theatres at 20 universities and further education colleges in Greater London. PARTICIPANTS: 2500 sexually active female students were asked to complete a questionnaire on sexual health and provide self-administered vaginal swabs and smears. INTERVENTION: Vaginal swabs from intervention women were tested for chlamydia by polymerase chain reaction (PCR) and those infected referred for treatment. Vaginal swabs from control women were stored and analysed after a year. Vaginal smears were Gram stained and analysed for BV. MAIN OUTCOME MEASURE: Incidence of clinical PID over 12 months in intervention and control groups. Possible cases of PID will be identified from questionnaires and record searches. Confirmation of the diagnosis will be done by detailed review of medical records by three independent researchers blind to whether the woman is in intervention or control group. TRIAL REGISTRATION: Clinical Trials NCT 00115388

Murdoch and the End of Ideology

Iris Murdoch had a lifelong interest in politics and she reflected upon the nature of ideology throughout her career. What she had to say on the subject developed during her career and relates to general academic discussions on the nature of ideology. At the outset of her career she was a committed socialist. She recognised that political ideology was in retreat after the Second World War but sought to contribute to socialist ideology. Later in her career she became sceptical of radical utopian ideologies, including socialism and developed a theory of politics that prioritised safeguarding individual liberty and security. However, she imagined that political thought would continue to develop and offer new possibilities and so she did not call for the end of ideology but continued to value political ideas

The genetic contribution of single male immigrants to small, inbred populations: A laboratory study using drosophila melanogaster

This study examined the genetic contribution of single male immigrants to small, inbred laboratory populations of Drosophila melanogaster. Genetic contribution was assessed by measuring the relative frequency of immigrant marker alleles in the first and second generations after immigration, while controlling for any selection effects at the marker locus, and for the experience of male immigrants. When immigrants were outbred, the mean frequency of the immigrant allele was significantly higher than its initial frequency, in both the first and second generations after immigration. There was no significant change in allele frequency for populations receiving inbred immigrants. The increase in allele frequency for outbred immigrants was attributed to an initial outbred vigour fitness advantage of immigrant males over resident males experiencing inbreeding depression. Hybrid vigour of immigrant progeny and the rare-male effect did not have a statistically significant role in the fitness advantage of the immigrant allele. The results suggest that inbreeding may have a considerable impact on the contribution of immigrants to the genetic diversity of populations

Reassessing Britain’s ‘post-war consensus’: the politics of reason 1945–1979

Since the late-1970s, scholars have been engaged in a vibrant debate about the nature of post-war British politics. While some writers have suggested that the three decades that succeeded the Second World War witnessed a bi-partisan consensus on key policy questions, others have argued that it was conflict, not agreement, that marked the period. This article offers a novel contribution to this controversy by drawing attention to the epistemological beliefs of the Labour and Conservative parties. It argues that once these beliefs are considered, it becomes possible to reconcile some of the competing claims made by proponents and critics of the ‘post-war consensus’ thesis. Labour and Conservative leaders may have been wedded to different beliefs, but they also shared a common enthusiasm for empiricist reasoning and were both reluctant to identify fixed political ‘ends’ that they sought to realise. Consequently, they were both committed to evolutionary forms of change, and they eschewed the notion that any social or political arrangement was of universal value

Reinventing grounded theory: some questions about theory, ground and discovery

Grounded theory’s popularity persists after three decades of broad-ranging critique. In this article three problematic notions are discussed—‘theory,’ ‘ground’ and ‘discovery’—which linger in the continuing use and development of grounded theory procedures. It is argued that far from providing the epistemic security promised by grounded theory, these notions—embodied in continuing reinventions of grounded theory—constrain and distort qualitative inquiry, and that what is contrived is not in fact theory in any meaningful sense, that ‘ground’ is a misnomer when talking about interpretation and that what ultimately materializes following grounded theory procedures is less like discovery and more akin to invention. The procedures admittedly provide signposts for qualitative inquirers, but educational researchers should be wary, for the significance of interpretation, narrative and reflection can be undermined in the procedures of grounded theory

A study of young peoples' attitudes to opportunistic Chlamydia testing in UK general practice

<p>Abstract</p> <p>Objective</p> <p>The objective of this study was to assess young people's perceptions of being offered a chlamydia screening test in United Kingdom (UK) general practice.</p> <p>Methods</p> <p>This is qualitative study that uses focus groups and individual interviews with young adults (age 16 – 18) to assess their views.</p> <p>Results</p> <p>These young adults were a difficult group to gain access to. Two focus groups, one in a school, the other in a general practice (family practice), and 2 individual interviews were undertaken (total sample 18). Respondents were unfamiliar with Chlamydia, but broadly aware of sexually transmitted infections. General practice (family practice) was perceived as an acceptable place to deliver opportunistic screening, but participants felt that tests should not be initiated by GP receptionists. Novel delivery routes such as schools and "Pub"/Bar dispensing machines were discussed. Issues around stigma and confidentiality were also raised.</p> <p>Conclusion</p> <p>Opportunistic Chlamydia screening in UK general practice (family practic seems acceptable to young adults. While this is a difficult group to gain access to for research, attempts need to made to ensure acceptability to users of this programme.</p

Communitarian perspectives on social enterprise

Concepts of social enterprise have been debated repeatedly, and continue to cause confusion. In this paper, a meta-theoretical framework is developed through discussion of individualist and communitarian philosophy. Philosophers from both traditions build social theories that emphasise either consensus (a unitarist outlook) or diversity (a pluralist outlook). The various discourses in corporate governance reflect these assumptions and create four distinct approaches that impact on the relationship between capital and labour. In rejecting the traditional discourse of private enterprise, social enterprises have adopted other approaches to tackle social exclusion, each derived from different underlying beliefs about the purpose of enterprise and the nature of governance. The theoretical framework offers a way to understand the diversity found within the sector, including the newly constituted Community Interest Company (CIC).</p

Circulating alpha1-antitrypsin in the general population: Determinants and association with lung function

BACKGROUND: Severe alpha1-antitrypsin (AAT) deficiency associated with low AAT blood concentrations is an established genetic COPD risk factor. Less is known about the respiratory health impact of variation in AAT serum concentrations in the general population. We cross-sectionally investigated correlates of circulating AAT concentrations and its association with FEV1. METHODS: In 5187 adults (2669 females) with high-sensitive c-reactive protein (CRP) levels < or = 10 mg/l from the population-based Swiss SAPALDIA cohort, blood was collected at the time of follow-up examination for measuring serum AAT and CRP. RESULTS: Female gender, hormone intake, systolic blood pressure, age in men and in postmenopausal women, as well as active and passive smoking were positively, whereas alcohol intake and BMI inversely correlated with serum AAT levels, independent of CRP adjustment. We observed an inverse association of AAT with FEV1 in the total study population (p < 0.001), that disappeared after adjustment for CRP (p = 0.28). In addition, the AAT and FEV1 association was modified by gender, menopausal status in women, and smoking. CONCLUSION: The results of this population-based study reflect a complex interrelationship between tobacco exposure, gender related factors, circulating AAT, systemic inflammatory status and lung function